摘要
目的观察腹腔镜胆囊切除术治疗急性结石性胆囊炎的临床疗效,以及术后炎症因子及血清淀粉酶水平变化。方法选取2021年1月-2023年3月在我院诊治的80例急性结石性胆囊炎患者为研究对象,采用随机数字表法分为对照组和观察组,各组40例。对照组采用传统开腹手术方案治疗,观察组采用腹腔镜胆囊切除术治疗。比较两组不同时间段疼痛评分、术后炎症因子[C-反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-ɑ(TNF-ɑ)]水平、血清淀粉酶水平变化、术后创伤应激反应指标[皮质醇(Cor)、去甲肾上腺素(NE)]、并发症发生率。结果术后2 h疼痛评分比较,差异无统计学意义(P>0.05),术后6、12、24 h疼痛评分均低于对照组(P<0.05);术后3天,两组CRP、IL-6、IL-8、TNF-ɑ水平均高于术前,但观察组低于对照组(P<0.05);术后3天,两组血清淀粉酶、Cor、NE均高于术前,但观察组低于对照组(P<0.05);观察组并发症发生率为7.50%,低于对照组的17.50%(P<0.05)。结论腹腔镜胆囊切除术治疗急性结石性胆囊炎临床疗效确切,可减轻术后炎症应激反应,降低血清淀粉酶、Cor、NE波动幅度以及并发症发生率,具有较理想的临床应用有效性和安全性。
Objective To observe the clinical efficacy of laparoscopic cholecystectomy in the treatment of acute calculous cholecystitis,and the changes of inflammatory factors and serum amylase levels after operation.Methods A total of 80 patients with acute calculous cholecystitis diagnosed and treated in our hospital from January 2021 to March 2023 were selected as the research objects.They were divided into control group and observation group by random number table method,with 40 patients in each group.The control group was treated with traditional open surgery,and the observation group was treated with laparoscopic cholecystectomy.The pain scores at different time periods,postoperative inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-ɑ(TNF-ɑ)]levels,changes in serum amylase levels,postoperative traumatic stress response indicators[cortisol(Cor),norepinephrine(NE)],and incidence of complications were compared between the two groups.Results There was no significant difference in pain score at 2 h after operation(P>0.05).The pain scores at 6,12 and 24 h after operation were lower than those in the control group(P<0.05).At 3 days after operation,the levels of CRP,IL-6,IL-8 and TNF-ɑin the two groups were higher than those before operation,but those in the observation group were lower than those in the control group(P<0.05).At 3 days after operation,serum amylase,Cor and NE in the two groups were higher than those before operation,but those in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was 7.50%,which was lower than 17.50%in the control group(P<0.05).Conclusion Laparoscopic cholecystectomy is effective in the treatment of acute calculous cholecystitis,which can reduce the postoperative inflammatory stress response,reduce the fluctuation of serum amylase,Cor,NE and the incidence of complications,with ideal clinical application effectiveness and safety.
作者
万汉朝
彭华敏
曹冬枝
WAN Han-chao;Peng Hua-min;CAO Dong-zhi(Department of General Surgery,Wannian County People's Hospital,Wannian 335500,Jiangxi,China)
出处
《医学信息》
2023年第24期61-64,共4页
Journal of Medical Information
基金
江西省上饶市科技计划项目(编号:2022CZDX123)。
关键词
腹腔镜胆囊切除术
急性结石性胆囊炎
炎症因子
血清淀粉酶
Laparoscopic cholecystectomy
Acute calculous cholecystitis
Inflammatory factors
Serum amylase
